Sign West Virginia RFP Secure

Document type sign rfp west virginia secure

start this morning first by saying welcome I think we all feel it has been a long time and quite the journey in getting our program up and running in the state and in revising and convening our library boards we're very excited to have you here together with us again today and especially excited to have a program now that is up and running effectively moving forward and so the role for this board is going to be extremely important in that in that movement ahead there has clearly been lots of it's happened since we last gathered and so I think today we will be spending us an amount of time looking at the review of where we've been a little bit of update the program progress and the work is really underway get your thoughts ideas input on that and then most importantly really speak to and think about the function and the structure and the role of the medellin kind of advisory board moving forward there will be a critical pieces of this work there is without doubt this is a in my mind a really critical group for this program I think that the medical cannabis program is really one that warrants and requires public input and process and really incredibly benefits from the wisdom and advice of experts from from various sectors and that really is you and the way we work together with that I'm going to stop there and let Jason do the roll call I realize we did not do that let him do the roll call and then I would ask each of you to do a very brief introduction of yourself we have several new members I knew and we've not convened for a while so I'd like to make sure that folks have a moment to introduce themselves put a name with a face and to share with us the expertise that you bring to the Advisory Committee so David you do the roll call and then we will move on from there thank you dr. Sloan dr. slam new member you're obviously here dr. beer he had notified earlier that he will not be able to attend Colonel Cahill hey this is I'm sitting in thank you Joe Deegan yes I'm here representing the West Virginia Association of alcoholism and drug abuse counselors and I'm a person in personal recovery from a substance use disorder okay our pharmacologist positions currently vacant dr. Easton left the state in resigned doctormick million new member doctormick million also pre notified us that you will not be able to attend Jessie Forbes I'm here today I'm an attorney from Kanawha County dr. Malia absolutely dr. berry good morning everyone I'm dr. Jim berry I am an addiction psychiatrist I specialized in both psychiatry and treating an addiction and chair of behavioral medicine and psychiatry at West Virginia University or prosecuting attorney position is currently vacant Russell Williams Russell Williams I'm a patient advocate I ended up in this role because after cannabis saved my life through cancer I've dedicated my life to ending prohibition so yeah nice to meet you all dr. Antle Laney new member I'm dr. Michael Anthony I'm family practice physician in Fayette County West Virginia also practice a lot of long term care and post acute care in nursing facilities in Fayette County dr. Milton good morning Clark Milton I'm an osteopathic internist in Wheeling West Virginia I'm the medical director of the Occupational as well as employee health I am the director of medical education now known as di o of Graduate Medical Education here I came as an ex-president of West Virginia osteopathic medical association and I try to be evidence-based good morning Joseph Hatton are you here Joe try that just am i here now yes okay sorry I was double muted Joseph hat and Department of Agriculture I'm Deputy Commissioner of Agriculture good morning and John Bernardin just a reminder to me unmute your mic Joe there John I can see John is online John are you able to unmute your mic yes that he's on me - no okay John can you hear us can you introduce yourself okay dr. slave it looks like we may have some technical difficulties with mr. Bernabe I think has joined us as well this morning and have him Thank You Kenny I'm bill crouch secretary DHHR just want to thank everyone for their participation on this it seems like it's been a long time coming here a lot of delays and a lot of a lot of issues that we had to overcome but I think we're on track Jason's a wonderful job and pushing this thing our interest is is moving quickly we have a statutory requirement to develop this program and and we want to make sure that we do that to best ability we can I like the comment about evidence-based that's that's important to us so we're we're looking at a lot of issues here's we do four but clearly we're on a path now to to to get this moving so just want to thank everyone for participating in this so we do want to move forward so we do have a quorum which is great this is going to be a meeting really with a lot of information sharing and opportunity for discussion of where things are we can kind of come together as a board regroup with with where things are and move forward the the first order of business is actually this review and approval of the previous meeting minute but before that I'd like to touch base on some of the duties of the board itself as we move forward if you you've probably received I believe as well a copy of the bylaws and so the overarching purpose of the board is really to advise assist and support as well advocate for the office of medical cannabis within the Bureau of Public Health and it really is aimed at bridging the gap between the program the medical cannabis industry physicians and patients most importantly there and so it really does provide a nice and I really appreciate the comments around evidence-based and the broad spectrum of expertise that all of you bring because that is what will we make a difference in this program it really is critical as we move forward together with that you'll see on the slide here the duties that are set forth by the code and many of these were established specifically in actions to be taken in the first year or two of the program or actually for the program again even when Cilicia law passed within the state and so that was the work of the advisory board up until the report that was issued in 2018 and so those really were specific to analyzing the laws looking at how other states we're doing this work making sure that there was public input and hearing and receiving and processing written comments and then developing a report to the legislature and the governor on how to do some of the wisdom and things advice moving forward these are the areas that the report covered it was addressing issues over loan related to the type of medical professionals who could issue certifications to patients there were recommendations around the types of medical conditions which would qualify as serious medicine conditions under the Act what kinds and form of medical cannabis would be permitted and then the numbers to to whether the numbers of growers propagated or dispensaries and as you know that has been issue that was in flux over the last legislative session or two and has had changed significantly since we began the process the next overarching emphasis and their ticket remains a critical piece of this is really how to assure ensure that there's a portable patient access that on cannabis how is it readily and readily available and affordable in that process and then finally the question that was posed at that point was whether or not to permit medical cannabis to be dispensed in leaf form or for vaporization and that actually did end up being enacted in 2020 so some of these have moved forward over time the advisory board just kind of give you some of the logistics of the board we do think it's important to have active participation and the expertise that you each bring so we do ask that board members try to do their absolute best to to attend all of our meetings we the majority of the members constitutes a quorum so we have met the quorum for today we really like to have more than a quorum though and really have good what we really value of course is the wisdom and the and the expertise that you each bring and that will only be what will allow us to the doctor business most meaningfully and really accomplish the functions of those words I'll go to the majority the members constitutes how we pass past actions there with that much of our work will really be born from the advisory discussion pieces of it we will have a few activities today that relates to actually require a boat or an action of the board and we typically use parliamentary procedures as well since we do meet quarterly we really do ask that there that folks try to attend those meetings we will be discussing today the role of some subcommittees and so we would anticipate those subcommittees meeting prior to the advisory board meeting so that we can really move the actions of those subcommittees forward and share information at the input across the advisory we're more broadly in those issues and then finally if the divisor a board member is not able to attend for three or more sessions consecutively the bylaws do speak to needing to touch base with that member to see if we need to have someone else who could actually who could spend more time committed to the process and then finally we do work and clearly in covent 19 we're testing this out we want to make sure that that the meetings are as accessible as possible and so if we are not able to be in person today we always want to make sure that there is an option of having an electronic mechanism to join in as well so I think we're all learning how to do that more more regularly so currently through through the current events of the pandemic if you need if we're not in person and we do need to join us electronically although we'd love to have you in person it is always a different dialogue that comes with that please do if you're not able to be in person let us know ahead of time that we need to do it electronically and we'll make that available to you and work work to make sure it any way we can to have you engagement involved and then the last highlight that they asked I share here was that we do and can appoint subcommittees so we will be talking about that today and looking at what those might be and we would ask for your active participation in those I think that's awesome in most advisory boards where a lot of the can get done in the process there any questions on the role of the board or the processes by which we work comments obsession questions some of you had work experience before that I have so happy to hear what worked well and what what what has been most effective for you in fact good conda's comment on that I think I appreciate the idea of looking into additional subcommittees I know in the past and that worked really well and we had to put the report together because we divided into work groups and we were really able to meet more often in a lot more detail and and put together presentations for the full board that then were voted on they were extremely helpful so I like the idea of trying to identify areas of the subcommittee's I also know that we do under the bylaws were supposed to meet quarterly and I know a lot of this was influx in the past with trying to get the legislative changes in place so I'm hopeful that maybe from today's meeting because we could set up a schedule and know exactly what dates and when we'll be looking at in the future for future quarterly meetings then obviously with hopefully with some subcommittee meetings in between that to report back thank you our course Olympus is Jason I need to make a quick suggestion to the members the public I cannot see the individual zoom window so please please let your name be known when you you make comments for the public and also for four minutes it just say that was Jesse Forbes talking in the last comments thank you anyone else related to to the board the role of the board was been effective what you'd like to see in the future with that let's move forward then to a a little more around old business here dr. Schlampe I apologize for interrupting again a couple quick suggestions this is Jason and it looks like mr. Bernabe has switched feeds perhaps he could introduce himself at this point and also I would suggest skipping back to approval of the previous minutes this is JJB I'm hoping that you can hear me I'm the representative for the West Virginia Board of Pharmacy I'm also a pharmacy owner and I currently am a retail pharmacist in the state of West Virginia we heard verbally not just by chat right now thank you so we do need to circle back to approval of the minutes from the last MCAD meeting you should have those they were sent out with the agenda and actually the discussion that we'll have subsequently here really reflects the work that was done in that meeting but you so I draw your attention to the minutes of the last meeting and ask there if there's any Corrections or changes to that and it's not to have a motion to approve the minutes to approve the minutes since Jesse Forbes work millisecond no I proved sorry Jason do you want to touch base here on the highlights of that last meeting and absolutely dr. slim thank you and just reflect for that for the public I'm Jason frame I'm the director of the office of medical cannabis within the Bureau of Public Health so for times sake I'm only going to touch on the report recommendations were adopted by the legislature the last meeting of M cam board focused on the creation of this report to the legislature and the governor recommendation 2.1 was recently enacted by the legislature by addition to our rules that recommendation was to include dryly for plan form and again that was enacted by rule include Raleigh for platform as an acceptable form of medical cannabis recommendation 3.2 was to allow vertical integration of growers processors and dispensaries the original version of the medical cannabis Act only allowed a company to be a grower and or a processor not either or of those and a dispensary again that has changed my company is now can apply for and hold permits in each of those categories recommendation 3.3 was enacted by the legislature this recommendation was was actually to examine the need for a physician or a pharmacist on-site at a dispensary during operations the legislature removed the requirement for a physician or pharmacist to be on-site at a dispensary during operating hours those were three recommendations enacted by the legislature back we've got a couple of areas we want to just kind of update you on for awareness purposes make sure we're all on the same page and so you know what's happened in the interim at last have some discussion around that any input that you would like to provide here there's two areas that we're going to be covering today in that arena one is the legislative changes there has been a lot of discussion debate and activity over the last couple of years in this arena is the program another in the program but the whole mechanism across state government of how to operationalize the medical cannabis legislation has been under way so we'll discuss update and lots of changes and then most excitingly the the development of the office of medical cannabis and the actual arm of this effort that will help move it forward to operations and lots of work by Jason and a new staff underway this is to make that hum occur there are a couple areas that we will have for action today one is we want to talk about the issue of the 30-day supply and we really need your input this is an area programmatically that we were really looking for a work group and one of our workers to address in the next few months or two is the what's the 30-day supply that we want to be making available through through their dispensaries so we'll have actions around or we'll have action towards a work group for that and then also some recommendations for the four work groups I think I'm Jesse brought up the importance of having work groups that are standing that we can look at some other additional work done and so we will have a have to have some discussion and want to kind of formalize what that structure is so the key thing for today I'm going to turn it over to Britt Ludwig who is general counsel for the Bur au of Public Health to give us a legislative update thank you doctor slim as dr. slim mentioned I'm presently serving as general counsel to the bureau for public health and some of these legislative updates have already been briefly mentioned by mr. frame but but we'll go through some of the highlights here significant changes were made in 2019 to the medical cannabis Act in West Virginia most notably as the slide indicates the conventional therapeutic interventions including opiate therapy to be contraindicated was removed as a requirement for the physician to certify a patient for medical cannabis use I'm sure many people on the or here can appreciate that it was an unnecessary hurdle to allow patients to have access to this therapy in addition the regional approach to distribute medical cannabis was removed from the Act that requirement would have had the bureau in the position of designating I think it was three regions for the state and distributing growers processors and dispensaries amongst those three regions there is some concern that enough dispensaries being located in areas of higher population density so that these therapies are available to the right number of patients that is still the regions have been removed but the location of dispensaries is still a consideration under the Act as it has been amended so that patient access is still consideration in the permitting process in addition the numerical scoring system was added to the act by the 2019 legislation and mr. frames office the office of medical cannabis is required to assign scoring to each of the elements that are considered under the Act for permitting and that adds a level of clarity to the process so that if there are contests down the road if pure permits are issued then we're applied for if any of the applicants want to contest the process or or now why they weren't given a permit this addition to the Act really aids his office in transparency and and allows permitting permittees to understand the process do you have page 13 there Jason you should be on page 12 breath okay in addition to Senate bill well that was House bill 1037 I believe but there was also a significant banking bill related to medical cannabis passed in 2019 as many of the members may be aware the program faced significant hurdles because of how the revenues from medical cannabis would be handled as as many of you know this is still not a legal thing in federal law so banking issues were a significant hurdle to the program and the legislature addressed that in House bill 2531 was in 2019 that established thanking services for medical cannabis it allowed the state to put out a bid for the banking services that would be completely separate from the other state revenue system so that those revenues are kept completely separate from other state revenues and this was a really important thing to the program as I'm sure everyone can appreciate if you can't handle money in this process you're not going to have a viable system and so that was that was really important in 2019 start going on to the establishment of the rules that implement the program the bureau for public health established five emergency rules early in 2019 as you can see on the slide there's 64 CSR 109 which handles all of the general provisions for the program it establishes the permitting process the other four rules address the process and program implementation for growers and processors for laboratories for dispensaries and then our last rule address the safe harbor letter that hopefully will be available to patients in West Virginia initially they were filed as emergency rules so that the program could get started and we could give notice to industry presence regarding the procedures that would be upcoming it is the act in West Virginia is fairly complex and so the longer the more notice we could give to industry the better prepared they would be to establish their businesses in West Virginia throughout 2019 there were several rulemaking efforts as I mentioned the rules were put out as emergency rules initially as part of the legislative rulemaking process the agency took public comments and and made responses to those public comments and then made some adjustments to the rule and filed those rules as agency approvals in July and then following the effective date of the legislation that passed in 2019 amendments were filed to those rules in September and the rules went through the legislative rulemaking and review process which began in the summer of 2019 and concluded with the passage of the rules bill by the legislature in March of 2020 and as mr. fraim mentioned the legislative action in 2019 did change one of the rules to permit flowering plant material is an acceptable form for dispensing in West Virginia and that is contained in our general rule and so there was significant legislation that made its way through the process in the 2020 session ultimately it did not pass that was Senate bill 742 and it was a quite would have implemented some very complex changes to the act it did not pass but the bureau expects to see legislation again in 2021 houseless basically the legislative update to the in a nutshell and pass it back to mr. Bray Britt would you like me to go back to the second slide on SB 1037 I'm sorry I'm well short thank you so I guess I missed a few things Senate bill 1037 also allowed vertical integration that was really important to the industry that was not permitted in the initial legislation and as mr. fraim mentioned in his synopsis of the minutes as this body recommended to the legislature the bill took out the requirement that a physician or pharmacist be on-site at a dispensary that would have presented a really difficult hurdle for many dispensaries and would have increased the cost I believe medical cannabis in West Virginia so they took that out and there were some other minor changes the tax structure was changed interestingly the point of taxation was shifted in this legislation from growers and processors to the dispensary point-of-sale so so that's basically it sorry I missed that last slide Thank You Brett frost doesn't follow that closely I'm sure I open it up for discussion there dr. slump this adjacent I would like to point out for the members that SB 1037 also increase the number of available dispensary permits from 10 to up to 100 that was a very significant change for the program this is Jody and I had a question that somebody wanted me to ask about whether hospitals or departments of hospitals could legally legally become dispensers is is language about that contained in the 64 csr 112 or is there any any any answer to that question that I have thank you so dr. dr. slim this is Jason I believe I can at least partially address that mr. degen when we have had significant interest from both hospitals and universities participating in the research side of our program and that's specifically addressed in the medical cannabis Act under that out we would permit those groups to conduct research and that could be on the growing process being or dispensing into patients and again multiple multiple universities within the state have reason reached out to us about participating in that research program however at this time we are heavily focused on making these products available to the larger patient group as soon as possible but definitely the the research component is something we're looking at no dr. slim I do not believe that there is this Clark Milton one of the challenges from a hospital standpoint if a patient has admit and being treated with cannabis once they're in the hospital how do you maintain that how do you dispense the that what happens in that situation and I think that's a question he'll probably have to be answered in the future just follow it up on that about I can envision a lot of hospitals and and and the medical professionals being concerned about the DEA certification if they're if there's anything close to where they're prescribing and they're admitted into the hospitals that may be something that ultimately we would want to look at some but but internally in the hospitals I think they're gonna have to make a decision of whether they would want to apply as a dispensary but I agree with Jason I don't think there's anything specifically in the law that prohibits them from doing that at least in the state law but they could run into some issues with federal law this this is Jason I believe those comments were correct perhaps is an internal decision for those groups there certainly are handling requirements and security requirements within the medical cannabis Act that as far as the actual way the products would be handled within those institutions may be an internal I'm sorry doctor dr. slain are you addressing that to me there's not other legislative issues or things to kind of catch up on or to update with let's say we move ahead to the program implementation so this is the area that we are excited to really see a program come to come together and be able to really move things forward and there's a ton of work we learned the complexities of this and the multiple pieces that have to fit together jason has and his team station has actually been on board for almost couple years now even before there wasn't he any program funding or need any an actual program but he really doesn't want to spend that time doing a ton of background research preparation drafting of programming with materials and tools and rules etc getting pieces in place so that when the program really would be officially launched we could we could jump right into that work so I have to put my hats off to to him and the work that he has done with that it has been complex and challenging and I think Jason can begin to speak today's a little bit on what what the issues are that he has been working on actively and where things currently stand lots of progress made and lots of work still to go so Jason do you want to launch into that piece of thing yes dr. slim thank you very much I also want to take a minute to thank the various groups that have been involved as you mentioned that the medical cannabis Act is complex and has taken a complex strategy to implement I want to thank secretary Crouch for his support the governor's office the Secretary of State Workforce West Virginia when a sturdy new tax department all those folks and many others have worked very hard to make this happen and provided a ton of documentation that's needed and called for within the act for one of these industry applicants so again thank you to all those folks and especially my staff for the hard work they've done so again get this implemented as as quickly as possible so I've put together a high-level overview what has occurred in the past with office medical cannabis and where we're going in the future so just to touch on each topic and we'll have some time for questions at the end so I wouldn't see receive dedicated funding from the legislature in july 2019 right after that the West Virginia treasurer's office I worked very hard to operationalize a home for the medical cannabis fund through an RFP process that the winner of that RFP process was element federal remedy and they will house the fees and taxes associated with once we received that dedicated funding in July like I mentioned earlier we immediately started hiring staff so far we have hired five staff and have immediate plans to add three more investigators that's been delayed very slightly due to coab in nineteen but we should have those additional three folks so on very shortly and with plans to add of course even more staff after that to help us implement this program folks in the industry physicians that we recently started registering I have worked through our vendor accompli to use our web-based registration program and again that's for industry patients physicians and caregivers that vendor has done a very good job in providing a web portal for those folks to register with with ONC the Act requires us to establish an electronic seed to sale program acquisition of that vendor is in the final stages at this point that contract should be in place very soon and will be made public this summer and again that's a basically an inventory system that our permittees will use to track every seed and every plant all the way to the purchase made of the dispensary by the patient that own seeds primary mission or one of our primary missions is to help prevent diversion of these products we only want medical cannabis products going to register patients so that system will be very very important and again we'll be in place soon we open the industry application process December 19th of 2019 enclosed it February 18th of 2020 we received 44 grower applications 41 processor applications 199 dispensary applications and one laboratory application since that time we have been working to evaluate the completeness of those applications that's been an extensive process some of these applications or our hundreds of pages long and are quite complex the Act did call for us to allow applicants to have a 30 day Correction period after that initial completeness evaluation that correction period is complete for growers and processors and will soon be complete for dispensaries we plan to start scoring grower applications first and that will happen immediately actually next week we'll start scoring processors will follow that and finally dispensaries of course that's also the order that they need to physically be built out so that's also how we're storing them DHH ARS office the laboratory services is in the process of purchasing equipment and establishing in-house testing procedures so they will also have the ability to test these products in-house beyond the commercial lab aspect though it will be in place om C has developed a patient ID card at this point and you see an example a generic example of that below this will be issued electronically Dave patient they can either use it on their smartphone or print it and bring it to a dispensary so this is a graphic again high level of implementation of the implementation timeline for the medical cannabis program as you can see in the middle of the page there the industry has six months byaku to be built out actually issue permits so again the permitting process will start this summer they'll have six months to build out once they're deemed operational following an inspection by the office medical cannabis facilities can have cannabis products on site meaning the growers can I have their first seeds or cuttings on site and start the production of those plants and then it will follow the production chain from there on the processors and finally dispensaries or access by patients we anticipate the first medical cannabis products being available to patients late spring 2021 again we have to have time for the industry to build out after we finish scouring industry applications our program mental sorry let me stop there and do we have any questions about about the progress of OMC so far oh sorry oh go ahead I was just gonna ask with respect to the the doctors registering where are we with that do we have registrations for the doctors to do the certifications and and how many have registered at this point if any yes it just real quick who's the question coming from sorry that is Jesse Forbes okay thank you mr. Forbes yes we opened the physician registry approximately a week ago I unfortunately don't have the exact date in front of me but we do have a register of physicians right now we've approved 10 so far we do have more in the queue for approval as part of that registration process the positions have to complete a 4 out our continuum in medical education course and then as I mentioned earlier they'll register through our online portal by cochlea once they register we at the office medical cannibis can approve them but we do have 10 approved at this point with with more to come shortly once we once we get closer to issuing patient cards we'll make those doctors public on our website and it may make them public well in advance of that so patients can establish a relationship with those physicians but the patients will have to visit those specific physicians in order to become become ertified as having a an ethical applicable serious medical condition can I follow up on that with the do you have an anticipated date and it's Jessie Forbes again an anticipated date for when the patients would be able to know who those doctors are so that they could start that relationship because I could envision that it may take a little time to get in and see and be evaluated to get the certification going and it seems like that might be a step that could somewhat easily be in a position where we can help speed that up sure you're absolutely right we will make that public well in advance and let me touch on another issue that's related the medical cannabis Act allows us to establish reciprocity agreements with other states it is specifically limited to terminally ill cancer patients but we are in active talks with other states regarding those reciprocity agreements we hope those negotiations are successful in which case again that small slice of our patient population we will be able to obtain their cards along with that of course they will need to visit a physician so that's another factor we'll have to consider when wind is starting to make that position less public and again we may do that sooner rather than later again we we've only had the position registry open for about a week so we'd like to like at least get through that initial rush of registrations before we put that public list out there but I would say if they'll happen sooner rather than later Clark Milton have a question and this may show that I didn't do my homework of those for our educational requirements for the physicians are they do they have to be approved by your office yes sir you're correct it does have to be approved by our office and there is a specific vendor that they have to go through the requirements for that physician training were quite stringent again it has to be approved as cm II nationally we did have quite a few vendors reach out to us in hopes of providing that education but most of them weren't able to meet that cme requirement so it is it is quite limited doc as far as the opportunities to provide that education and second question and this may be a board and licensed your issue I know on their higher side I'm using that as a model only as that there's a rare there's a certification that I believe it's a CT are certified to recommend because we shouldn't prescribe based upon other issues that were brought up by mr. Forbes with regards to licensing and E and DEA will that be available or this just list will be available from your office so the structure of the medical cannabis act in West Virginia is a little bit different the physicians function in this process is only to certify that the patient has an applicable serious medical condition and I'm not going to speak for the legislature but the way to actual written once once the patient is deemed as having a serious medical condition the decision that they're eligible for medical cannabis has really been made by by the act itself again the physician is only saying that they have an applicable condition now the physician does have the option to limit the forms or duration of medical cannabis the patient can can obtain but again the physicians primary function is to only say that the patient has a serious medical condition you're correct and I should have mentioned that but and that'd indemnifies them based upon those DEA issues that were mentioned earlier okay thank you thank you just one other question Joe vegan here this application process that closed on February 18th is that going to open up again for others who may be interested in applying I'm talking particularly folks who are interested in being dispensaries so mr. dickham there are a couple of scenarios and this is Jason sorry there are a couple scenarios where that could happen number one if we don't issue all the available permits based on either scoring of applicants or geographic location when you could consider opening that system back up under our current permit quota allowed by that act which is up to 100 dispensary prevents the second scenario would be if the legislature changes the law and basically adds to the available prevent quota that being said the first scenario I believe at this point is unlikely we did receive significantly more applications than there are permits available rusty Williams I've got a question about the the testing facilities did I hear you correctly did you say only one application was submitted for a testing facility yes that's correct rusty and we are in the process of addressing that it is quite the project to establish a testing lab for medical cannabis the testing parameters are extensive based on our research it looks like just the equipment cost is going to be approximately two million dollars and also you have the personnel costs on top of that so we did receive only one application but the lab process is a little different than the grower processor and dispensary industry side there are no limits to the amount of laboratories that can be in West Virginia I personally I believe the limiting factor is again that large investment that's necessary but because we did receive only one lab application we are in the process of opening those application opportunities back up we're going to announce that publicly very shortly but there's no reason for us not to allow perhaps more interested party to the lab side to apply we are we are in the process of doing that as I mentioned the second way we're addressing that as I previously mentioned OLS on our office of laboratory services is moving to be able to provide this testing service in-house if needed our primary goal is to make sure there aren't any roadblocks in obtaining patients obtaining products because the lack of laboratory capacity so we will have that as a backup also to provide that quality improvement or quality control kind of testing there were a question with things as well but we feel like it's important to have the capacity to do the service if we need to you're correct dr. slim this is Jason their original intent and then Tim Steele is for them to be that Qi process to make sure make sure products are safe for patients but you know in a worse case scenario they couldn't provide testing for the products the products can't move the market without having the full testing suite as required by law but we hope once we get the lab application process open back up though we may receive more more applicants and several several companies have expressed interest in in applying to be a laboratory they said how are you reaching out these might describe a little bit how you're reaching out to providers so they are really attuned to and know about putting an application for being able to certify sure absolutely we we have reached out to physicians through their respective boards the the DA board and the m.d. board they sent out emails to their members and also through their their newsletter to reach those folks and we also did a press release so that was available to the general public so we have had done some work to make physicians aware that they can register to participate in this process absolutely and this is JJ Burnaby I just wanted to ask a general question about the banking issue in the state if we could maybe get into little update on that yeah but this is Jason I can address that and I want to be careful not to speak for the West Virginia treasurer's office but but they have done an excellent job addressing that issue starting with RFP process they did have several applicants to provide those services as I mentioned earlier the winning applicant to provide financial services and how's the medical cannabis fund was element Federal Credit Union that account has been established and we deposited all the fees associated with the application process into that account so it's working well does that address your question yes I just knew that there was initially a concern with money and checks in a bank as far as state versus federal rules and it sounds like by enclosing the bank within the state I guess we we've kind of remedied that correct and again that that process has been working well as Britt Britt mentioned earlier the legislature did make a change to the law to allow trade unions to participate in that process and once that once that change was made things progressed fairly quickly to bring element on board as they as a vendor and against the house that medical cannabis or doctor sleep I think the Advisory Board can provide a good perspective that different segments of industry made you the medical cannabis Act and the the program has we have positions on the board pharmacists lawyers there's patient advocate and I think those folks could provide OMC again a perspective that we may not may not have ready access to otherwise I think their opinion throughout this process is going to be very valuable sure absolutely I'm going to move to the next slide this is an area that we've identified for the board's consideration there has to be a 30 days supply limit set for products the patients can obtain at dispensaries plant material I'm not gonna say it's easy but it's fairly straightforward those states limit the cells of plant material to four to six ounces per patient per month we have a lot of good examples with that it seems to work well in other states the concentrates are a little more complicated though due to the vast differences in THC content and the methods of administration of these concentrates we think board input would be very valuable and establishing those limits OMC would like to limit those purchases by total milligrams of THC purchased per 30 days but again establishing what that limit should be for concentrates is a very complicated subject and we would certainly value the board's input on making that decision something else very related that we could consider that's not mandated by and by the code but I think it's worth considering is perhaps limiting the percentage of THC in these products that is an option and I think it's worth discussion that may may give a long way towards negating some of the concerns that people may have about these products if we limited women thin to a certain percentage of THC we'll address this later on in there the the meeting that OMC suggests that a work group people are to address this this question do we have any any perhaps questions from the members surrounding this topic not a question as much as a comment Jesse Forbes again so it seems to me I mean I think it makes a lot of sense to put this into a work group but hopefully we could look at what other states have done in these areas because you know we don't need to be inventing the wheel here with as many states as already enacted medical cannabis laws and already have programs up and running hopefully we can find some that we like from that in this process and and you know borrow the good parts and put something together relatively quickly but I think it does make sense that there needs to be some kind of limits to make sure that this this stays honest to what it's supposed to be thank you mr. Forbes and oh em C has been doing that research on other states and their limits I in preparation for this decision and we'd be happy to share that with the board and also of course the for group that may be formed to address this other thoughts repeat feedback in terms of things to add into that workgroup or to consider so they will get the trails of other states there may be other resources are you all aware of or items to consider this that you want to make sure feed into that be very helpful to have a board input on that piece of it I believe this is Jody gonna yeah I definitely think we need a workgroup looking at the percentage of THC in the products because I think that's gonna be a you know a hot point hot button point that that we're gonna run into you know just with the public and and then with feedback from all parts you know just basically you know limiting the amount of THC in the product so I agree that we need a work group on that are we going to get a chance and also to make recommendations for other work groups rusty Williams I've just got a question here when we're talking about work groups has there been any discussion we are one of the most economically depressed states in the country has there been any discussion about adding the charge as to whether or not to look at allowing patients to grow limited amounts for their own personal use I think that's important is that something that we could add to a work group to look into doctor sleep this is Jason and I'll certainly defer to yourself and Brett on this but I believe that the mcat board can make recommendations to the legislature on a wide variety of subjects but ultimately it will be up to the legislature to that topic cast came up in the legislature multiple times and let me go ahead and move to discussing about work groups actually and so here's we want to make sure we have a structure that will allow for [Music] brought what kind of wide array of topics to be managing and thought through carefully work groups and so there were three that we kind of put together at the proposed grouping of those and then to fit things into each of them so I wanted to propose these three get your thoughts on them and then maybe touch base about the kinds of topics that might fit into some of these so the three that we had come up with we're thinking one you know we're starting a new program we're learning about how this works in the state we want to make sure we've got good understanding of patient experience and effectiveness and a whole host of things so one area was around research and data and we like to think about about folks thinking in advance as we move forward to make sure that we really have a good qi system and process in place feedback understanding of issues and also advancing the research agenda that's listener to the act the the second area was the health and medical and so that's we were for instance potentially probably where we would put the 30-day supply question potentially some other arenas obviously and then the third one proposal topic was kind of a broader policy and program support so that if there were program topics or policy measures that we wanted to get input on or help shape in the interim etc that that would be opportunity to do that for the program I'll just put those out there and get feedback response about that proposed structure or other modifications thereof and what you might think about fitting into each of those okay can i comment on that jessie Forbes so I think those are all the good broad can korie's and things that the board needs to certainly be looking at I know I've looked at what other states have done in terms of their subcommittees and they seem to fit right in line with what states that have been down this road before I've looked at one area that and I wonder where it would fit in this and it in my mind probably in the policy and program area but but what everybody else thinks last the last time we split up to do the report the workgroup that I chaired one of the things we looked at was patient affordability and patient access and I think that's still really really important to keep that sort of paramount and it kind of it dovetails into the ability for the businesses that want to be in these areas and in these arenas being able to have what they need in place to get this product out in a way where you know as I think rusty said a minute ago I mean we're one of the poorest states in the Union unfortunately just from a socio-economic standpoint and this isn't a product that insurance is going to cover this is not something that you know people are gonna have to find a way to get this that are in dire need of it suffering from cancer and and other other causes so I think it's really important that we keep some look at patient affordability and patient access and and I just wonder if if the department has any ideas of where that would fit in these categories in my mind probably under the policy and program support area but but I'd be interested to see what everybody else thinks other way you could do it is actually create another group that has worked a b t more around patient experience and with that well that could fit into crops actually several of those arenas yeah I would think we've been in the policy arena and also the research and data just in terms of what's happening and how acceptable is it for folks this is gym vegan again the question had raised about hospitals being able to participate but as dispensaries because there's going to end up being like patients end up being in the hospital that would would have you know and then have access while they're in the hospital if that could be a part of the subcommittee you know looking into that I don't know how we would approach that but you know seeing whether or not hospitals or other types of individuals that we that we haven't really looked at if it could be a part of the dispensary process or even any of the other areas processing and growing but I'm you know I'm focused more on the dispensary piece because of the questions I've received from individuals in the community so I'm asking whether or not that could be also a part of the discussion of our subcommittees you know I would think under policy and you know that that to me is like a policy issue be good to have some legal yeah some some folks that have some legal advice as far as input or at least give some direction other topic we might think about I'm going to do Darien yeah rusty Williams there's a you know there's actually well you guys have talked about capping THC levels has there been any discussion of potentially capping product prices because one of the issues you know where we modeled our our legislation after Pennsylvania I've talked with a lot of patients in Pennsylvania who are still having to utilize the black market just because dispensary prices are so high that's another reason that you know I really think that home grow that's got to be part of this discussion because we do have a lot of patients folks on Medicare and Medicaid have basically been priced right out of their medication in Pennsylvania and I want to make sure that when this program is implemented here that those folks aren't left out in the cold here so has there been a discussion you know as far as capping products prices rusty this is Jay's tonight I can address that at least partially OMC and the West Union tax berman are are mandated in code to monitor medical cannabis prices now this this market doesn't exist at this point that we are mandated to to have a look at that by law thank you you know you're raising issues that also makes me wonder further let me begin a new program we want to make sure you have you're capturing information it's occurring and you understand how the markets working or how the experience is and I wonder if there are people can think about and maybe this is some work yet to go but I kind of like the speed what what are the things that we want to look at now and as we implement this program to look at and see and understand impact quality experience effectiveness so those one of those research questions what are those cause we want to put in place that we we tracked we know that we are reaching the market that that folks are having access to it those kinds of data quality and safety questions begins to say what are those hypotheses one of those questions we want to make sure both programmatically that we so we were able to capture and then also the larger research questions that we can we can pass on to and work with universities this is Jim berry I'd say a couple of things come to mind as far as important questions specifically regarding monitoring psychiatric admissions or psychiatric sequelae related to cannabis and also rates of cannabis use disorder as availability becomes more prominent rates of suicide etc so just general psychiatric and addiction issues that are going to be really important to follow this is this is Jodi and again I agree with dr. Barry I think I think those things really do need to be studied and tracked throughout this whole process well maybe one area would be you know what we did early on we reached out to the doctors that had patients that qualified to get their their input in a survey and I'm wondering if there's a way to try to do that again - once the program is up and running to see in particularly people that have that treat folks that have these conditions are they utilizing this program and and and and try to get some kind of data of what you know what sorts of percentages of folks in the state that have these conditions are actually utilizing the program also want to make sure we do things in understanding patient access to and this is exactly distribution correct etc so overall I'm hearing that these three areas we can capture most things into this area these three areas and you recommend a changes to those workgroup structures Jodie and I I agree with you dr. slam I think those three areas could cover pretty much everything that we're talking about at least yes absolutely as I mentioned earlier we very much welcome input from these workgroups and the larger board overall yes yep sorry Jodie get everybody opposed all right and then we need to think about populating the workgroups so if you could think what which work would you like to take part in that'd be very helpful and send your maybe you could send a first second or third choice priority to Jason that works Jason dr. slim Bob if you're agreeable OMC will fill eight that process and by email and see which members I would like to participate in which workgroup and well of course keep you informed during that establishment process we will help prioritize which ones that would be most helpful for moving forward currently our goal really right now is to get a program up and running and and active so we've got product out there the priorities been good at moving really helpful anything else on five three committees that one set let's talk about steps forward in terms of setting the next date in form I'm thinking we want to do this quarterly so we are now in June is there a September time period it would be good Jason do the time period that you would think would be appropriate then so if we stick with the quarterly time frame again just mid-september would be fine from an ONC perspective unless any members have a commitment already scheduled during that time we could stick with the seventeenth that's a Thursday in September yes we can we can certainly do that unless they happen to fall on a holiday but again we can facilitate developing that schedule and send it out to to the group the quarterly given that we can have work groups um working between workers time too to do some of the background piece doctor slam pop this is Jason I would like to ask perhaps for a member input on whether this time the day works for them or perhaps they would rather have it moved to an evening we would like to do whatever is most helpful to the members Jim berry this time works for me Jared Iggy this time work for me also and then do you have a preference in terms of in person versus versus virtual given although we'll have to see where we are in terms of pandemic at that points but we're not in the academic world what do the vaccine etc give you have a preference in terms of virtual versus in person [Music] Jesse Forbes up I'm performing eventually obviously dr. slip you know more about the pandemic issues than the rest of us likely here at least me but ultimately I'd like to for us to be able to get back to in-person meetings especially because of the the public input we've had in the beginning of this we had some really terrific public input at these meetings a lot of people I mean people from all walks business community folks patients I mean everyone coming to these things that had a lot of interest and I think it makes it a lot easier to have their voices heard I'd also suggest if we get to that I know we did this previously with we did the meeting in Morgantown but if there's a way eventually to get to where we can do in-person and do those in different areas of the state regionally to let let people's input come in and then maybe perhaps keep a virtual option obviously for folks that are concerned or if you know there's a there's a flare-up in the numbers and and we've got go back something related to code that but at least my two cents would be that we we try to get this to in person you know obviously maybe not September may not be a timeframe to do that but at some point we get this back to an in-person meetings I would have the same goal I think it's a whole different dynamic and availability so really listen to folks in here and interact with it yeah Jody I agree with Jesse I think that I think the public you know it's really gonna want to be able to participate live if that's possible [Music] alright the topic for a session for next time I'm assuming that we would have report out to the workgroup they would be they would be working on the interim other figure out high level topics you wanna make sure we capture next time it's Jesse Ford's I just want to make sure for the next meeting we get an update on where the progress is with with actually rolling out and awarding the bids and just to follow up on that I know Jason you said that that process you expected could go into the fall is there a timeline for when that would end and and and when you expect to actually have the the the bids awarded and to where we can get this rolling out because I know it was mentioned that spring 2021 now is what we're looking at I know that it's been a long time coming trying to get this program actually out to the public and obviously prior meetings to advocate as quick as we possibly can and and and I understand that you guys are doing what you have to do to get there but is there a time frame for when that that process would end and can we make sure that's on the agenda next time to get an update on sure absolutely mr. Forbes we anticipate ferment awards ending late summer early fall for dispensaries but again the scoring process at least in our state hasn't been done before we're going to start with growers sake and go from there but it's difficult at this time for me to give a good good estimate of how long that process once we once we go through the grower permits we'll have a lot better idea but at this point it's just difficult difficult to judge this is Jim berry I'm just curious and if it's the information is there I apologize but is there been any discussion about adding then that is for patients who have been dispensed that they have this would be captured in their prescription drug monitoring program database like other controlled substances are dr. berry this is Jason I believe that's a conversation we we would have to have with the Board of Pharmacy to to get their input and I just wonder if it falls back to the issue of whether you know we have to be cautious to make sure that this isn't in any way construed to be prescribed by someone because otherwise the right you run into serious federal issues for the doctors that certify so may I did something I think maybe we could try to maybe maybe one of the workers can look at whether that's something that makes sense to do and maybe get some some input from the pharmacists and obviously the doctors I think that would be a good topic for a work group thank you dr. Slynt this is Jason if I could have one more topic for consideration one of the primary charges of the medical cannabis board is to consider new forms of medical cannabis or new serious medical conditions the office medical cannabis would like to continue to implement the medical cannabis act as it is but I would suggest the workgroups look at perhaps just a procedure to bring those considerations to the board we've already done some work on that and I think getting that again at least procedure in place at a time might be valuable in first one of the workgroups may want to examine that all right you know well I will I think that me I think high up so most of our agenda actually we do want to make sure that we have a process and we announce the process here for public comments you've got muscles I'm sure that our following and listening and we want to make sure that they are have an opportunity to submit comments and actually by code those are to be by written comments so we really think that's critical so we would ask here and and that any public comments be accepted and with until July 1st we just need a timeframe that we can get those in so that we can get them compiled and back out with a list of a meeting so those will be sent by email to the email address on the screen which is med tan WV MeV CA n WV @ WV gov and if you could put in the email subject line MCA VM cab needing public comment so M cab meeting public comment by July 1st 2020 to the medc n WV @ WV gov email address that would be great we really value and appreciate public comments coming in and that's a really critical part of the process to make sure that those those get synthesized and before the board so for their evaluation and action other thoughts ideas Jason was doing anything else from the public comment no again if the public could just please put that email subject line in and dr. sleep I'd also like to take just a second to thank the western media office of Technology for a providing technical support to make this virtual meeting yeah they were extremely helpful anything further before we close out today we Jason is you gonna forward the public comments on to the board members so we can get those means that the process for that yes I would like to wrap them through one of the established subcommittees but yes the intention is to off only give those public comments to the board itself look there's not music any other questions or thoughts the way to do that anything else for the good of the order I will what if they thank you to everyone who has spent the last hour and a half with us here today we're really excited to have the group reconvene and active and to establish a working structure that we will be able to do a lot of the work of the board and and the work that we're really I think continue to advance the program visibly with the goal of getting safe and affordable product to two individuals and the relative that can benefit from it as quickly as possible and to do that in a effective manner with that so we really appreciates the input and to know that you all and your work will in your expertise will be critical to making that happen and look forward to working with each of each of the work groups in the next few months and then very convening in September thank you for being here and we look forward to ongoing collaboration together something else further than to say I would just give you an extra 20 minutes or your day or so and say thank you very much for being part of the other meeting thank you boys wonderful West Virginia date is Friday celebrate our state thanks